Structural hepatic changes associated with cyanamide treatment: cholangiolar proliferation, fibrosis and cirrhosis

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Abstract
— The authors present the clinical and histological findings in a series of 42 liver biopsies from 39 chronic alcoholics treated with cyanamide as aversion therapy. All biopsies displayed characteristic cytoplasmic inclusions in the liver‐cells. Fibrosis and disruption of the parenchymal‐connective tissue interface were observed in all cases. According to the severity and extension of fibrosis, three stages could be depicted: Stage I. Periportal activity cholangiolar type (ACT), which is defined by cholangiolar proliferation, fibroblastic activation and inflammatory infiltrate, which together cause a blurred appearance of the parenchymal‐connective tissue junction. It is the elementary lesion and was observed alone in 26 biopsies. Stage II. Portal‐to‐portal linkage. It was observed in 10 biopsies, all of which also showed periportal ACT. Three of these came from patients with two biopsies in which transition from stage I (first biopsy) to stage II (second biopsy) was observed. Stage III. Nodular parenchymal regeneration, associated with changes observed in stage I and II. It was found in six patients. The histological picture resembles the biliary type of cirrhosis. There is a clear‐cut correlation between the length of treatment and the stage of the hepatic lesion.